Ortho Pedo Seminar The presentation is only for the dental praticioner.

1. CHILD’S BEHAVIOR
MANAGEMENT
GLO ARBY ARGUELLES, DMD

2. CHILD’S BEHAVIOR MANAGEMENT
o The foundation of practicing dentistry with children is built on the ability to guide them
through their dental experiences.
o More long-lasting beneficial effects can result when the seeds for the future dental
health are planted early in life.
o A professional goal is to promote positive dental attitudes and improve the dental
health of society.

3. CHILD’S BEHAVIOR MANAGEMENT
o A major difference between the treatment of adults and children is the relationship.
o ADULT - one-to-one relationship
> dentist-patient relationship
o CHILD – one-to-two relationship
> dentist-pediatric patient and parents or guardians.

4. PEDIATRIC TREATMENT TRIANGLE

5. AGE-RELATED PSYCHOSOCIAL TRAITS AND SKILLS
 GEARED TO GROSS MOTOR SKILLS
 LIKES TO SEE AND TOUCH
 VERY ATTACHED TO PARENT
 SOLITARY PLAY; RARELY SHARES
 LIMITED VOCABULARY; EARLY SENTENCE
FORMATION
 BECOMING INTERESTED IN SELF-HELP SKILLS
 FEARFUL IN SUDDEN MOVEMENTS
2 YEARS

6. AGE-RELATED PSYCHOSOCIAL TRAITS AND SKILLS
 LESS EGOCENTRIC
 LIKES TO PLEASE
 VERY ACTIVE IMAGINATION
 LIKES STORIES
 REMAINS CLOSELY ATTACHED TO PARENT
 DENTIST CAN ENGAGE QUESTIONS
3 YEARS

7. AGE-RELATED PSYCHOSOCIAL TRAITS AND SKILLS
 TRIES TO IMPOSE POWERS
 PARTICIPATES IN SMALL SOCIAL GROUPS
 MANY INDEPENDENT SELF-HELP SKILLS
 KNOWS “THANK YOU” AND “PLEASE”
 HEIGHT OF “FEAR OF BODILY INJURY”
4 YEARS

8. AGE-RELATED PSYCHOSOCIAL TRAITS AND SKILLS
 A PERIOD OF CONSOLIDATION; DELIBERATE
 TAKES PRIDE IN POSSESIONS
 RELINQUISHING COMFORT OBJECTS
 PLAYS COOPERATIVELY WITH PEERS
 FEARS ARE GENERALLY REDUCED
5 YEARS

9. AGE-RELATED PSYCHOSOCIAL TRAITS AND SKILLS
 Elementary school children.
 Developing independence from parents.
 Peers becoming increasingly important,
and affect behavior.
 Able to resolve fears.
 Desires acceptance, therefore more
compliant.
 Adjusts easily.
 Can tolerate unpleasant experiences.
6 -12 YEARS

10. CLASSIFYING CHILDREN’S COOPERATIVE BEHAVIOR
An understanding of behavior in children can be an asset to the dentist in several ways.
Cooperative children are reasonably relaxed, minimal apprehension and enthusiastic.
In contrast, is the child lacking in cooperative ability. This category includes very young
children where communication and comprehension is not yet established.

11. FRANKL BEHAVIORAL RATING SCALE
FRANKL 1
- RATING 1
- DEFINITELY NEGATIVE.
- Refusal of treatment, crying forcefully, fearful, or any other overt evidence of extreme negativism.

12. FRANKL BEHAVIORAL RATING SCALE
FRANKL 2
- RATING 2
- NEGATIVE.
- Reluctant to accept treatment, uncooperative, some evidence of negative attitude but not
pronounced.

13. FRANKL BEHAVIORAL RATING SCALE
FRANKL 3
- RATING 3
- POSITIVE.
- Acceptance of treatment; at times cautious; willingness to comply with the dentist, at times with
reservation, but patient follows the dentist’s directions cooperatively.

14. FRANKL BEHAVIORAL RATING SCALE
FRANKL 4
- RATING 4
- DEFINITELY POSITIVE.
- Good rapport with the dentist, interested in dental procedures, laughing and enjoying.

15. DENTAL MANAGEMENT TECHNIQUES
NON-PHARMACOLOGICAL
METHODS

16. DENTAL MANAGEMENT TECHNIQUES
1. COMMUNICATION
- Hallmark of a successful dentist in managing children is his/her ability to communicate with them
and win their trust and confidence.
- Effective communication with children is critical for gaining the child’s cooperation to receive dental
care.

17. DENTAL MANAGEMENT TECHNIQUES
2. TELL- SHOW – DO
- A technique of behavior shaping used with both verbal and non-verbal communication.
TELL > involves an age appropriate language and explanation of the procedure.
SHOW > is used to demonstrate the procedure.
DO > performing the procedure.

18. DENTAL MANAGEMENT TECHNIQUES
3. MODELLING
- The basic modelling procedure involves allowing a patient to observe one or more individuals
(models) who demonstrate appropriate behavior in particular patient.
- Stimulated models : films, videos, audiovisuals, clips, posters can be used to reinforce the desired
behavior

19. DENTAL MANAGEMENT TECHNIQUES
4. POSITIVE REINFORCEMENT
- Presentation of reinforces which increases the frequency of desired behavior.
• TANGIBLE REINFORCEMENT
• There is a general agreement on the merit of this practice in the dental office, for gift giving can serve as a reward.
• Toothbrush kit
• Tokens for children, as affection, not bribes.
“A bribe is promised to induce behavior. A reward is recognition of good
behavior after completion of the operation, without previously implied promise.
- Finn

20. DENTAL MANAGEMENT TECHNIQUES
4. POSITIVE REINFORCEMENT

21. DENTAL MANAGEMENT TECHNIQUES
5. VOICE CONTROL
- Sudden and firm commands are used to get the child’s attention or stop the child from whatever is
being done.
- Monotonous, soothing conversation is supposed to function.
- “Stop crying and pay attention” may be necessary preliminary measure for future communication.

22. DENTAL MANAGEMENT TECHNIQUES
5. VOICE CONTROL

23. DENTAL MANAGEMENT TECHNIQUES
6. DISTRACTION
- It is a technique used to divert the patient’s attention during the unpleasant procedure.

24. DENTAL MANAGEMENT TECHNIQUES
6. DISTRACTION

25. DENTAL MANAGEMENT TECHNIQUES
7. RETRAINING
- Retraining approach is when the child had a previous unpleasant experience from a dental office.
- The dentist’s goal is to build new series of associations in the child’s mind.
- The child then develops a new perception of dental office and relationship to dentistry.

26. DENTAL MANAGEMENT TECHNIQUES
7. HAND-OVER-MOUTH TECHNIQUE
- This method is established communication with children who are able to cooperate, but exhibit a
hysterical behavior to avoid treatment.
- A dentist’s hand is placed over the mouth of a child and told that the hand will be removed as soon
as appropriate behavior begins.
- When the child responds, the hand is removed and praise for his good behavior.

27. DENTAL MANAGEMENT TECHNIQUES
8. PHYSICAL IMMOBILIZATION
- Are used to provide partial or complete immobilization of the patient to protect the
patient and dental staff from injury while providing dental care.
- Physical restraints
- Papoose Board
- Pedi Wrap
- Triangular sheet
- Mouth Prop or bite block

28. DENTAL MANAGEMENT TECHNIQUES
8. PHYSICAL IMMOBILIZATION
- PAPOOSE BOARD

29. DENTAL MANAGEMENT TECHNIQUES
8. PHYSICAL IMMOBILIZATION
- PEDI WRAP

30. DENTAL MANAGEMENT TECHNIQUES
8. PHYSICAL IMMOBILIZATION
- MOUTH PROP OR BITE BLOCK

31. DENTAL MANAGEMENT TECHNIQUES
PHARMACOLOGICAL
METHODS
…TO BE CONTINUED